MS. Susan De Tarr, M.S.W., CADC 1

NPI #1104006725 in Albany, Oregon

Provider Information

NPI Number: 1104006725
Entity Type: Individual
Name: MS. Susan De Tarr, M.S.W., CADC 1
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Social Worker - Clinical
Credential: M.S.W., CADC 1
Enumeration Date: Nov 12, 2007
Last Updated: Aug 16, 2023

Practice Location

Address: 2225 PACIFIC BLVD SE STE 101
City: Albany
State: Oregon
ZIP Code: 97321-7903
Phone: (503) 655-8264

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor - Addiction (Substance Use Disorder) — Addiction (Substance Use Disorder)	101YA0400X
Counselor - Mental Health — Mental Health	101YM0800X
Social Worker - Clinical — Clinical	1041C0700X	Primary

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